Sue
Pawar-Price

Sue is a dual-qualified lawyer (solicitor/barrister) with 19 years of experience in the insurance sector. She started her legal career as an in-house solicitor with a large composite insurer before spending the next 10 years in private practice. She worked at two of the market leading insurance law firms and worked her way through the ranks to set up, develop and head large teams of specialist fraud lawyers.

Throughout her career, Sue has run her own caseload of high-value and technically complex insurance fraud cases. She has worked with some of the country’s leading experts in fraud, including counsel, medics, engineers and industry organisations.

Called to the bar in 2010, Sue completed her training at the Criminal Bar (Citadel Chambers). This enabled her to further develop her knowledge and expand her experience in fraud cases. During this time, she marshalled a number of judges on high-profile Crown Court cases. She regularly prosecuted and defended cases and was retained as an advocate in the County Court, High Court, Youth Court, Magistrates' Court and the Crown Court. It was at the Criminal Bar that she developed her knowledge of private prosecutions and advised insurer clients and other commercial organisations on the merits of pursuing this route.

Sue's insight into the insurance industry, combined with her wealth of experience in private practice, the civil arena and, more recently, the Criminal Bar, puts her in a unique position to provide her clients with a truly holistic approach to every case she is instructed on.

Sue has lectured to the members of EHFCN (European Healthcare Fraud and Corruption Network) as well as the Insurers of Europe in Brussels, HICFG (Health Insurance Counter Fraud Group), IFIG (Insurance Fraud Investigation Group), IFED (Insurance Fraud Enforcement Department), ACII (Association of Chartered Insurance Institute), brokers, insurers, health care providers, Lloyds Syndicates, specialist investigation firms and Loss Adjusters. She has also provided technical training to many lawyers in the market. She is keen to provide further seminars, presentations, workshops, clinics and knowledge cafes.

Undertaking both claimant and defendant work, Sue continues to specialise in insurance fraud as well as general personal injury litigation to include RTA, EL/PL and slippers and trippers involving the following issues:

• LVI
• Bogus passenger claims
• Induced accidents
• Staged accidents
• Tort of deceit
• Exemplary damages
• Exaggerated injury and loss
• Fraud Rings
• Fraudulent credit hire claims
• Private prosecutions

Complex insurance arguments including non-disclosure/misrepresentation issues as well as issues arising out of insurance contracts, the Road Traffic Act and the MIB agreements Costs Sue will provide drafting, advisory and advocacy services, including disposal hearings, interlocutory hearings, fast track and multi-track hearings.

Healthcare Fraud

Sue has worked very closely with a number of counter fraud organisations in the UK, Europe and USA, which are at the cutting edge of healthcare fraud in both the public and private sectors. She understands the complexities of these sorts of cases and is keen to take on cases involving the following issues:

• Billing for services not rendered
• Billing for non-covered service as a covered service
• Misrepresenting the dates of service
• Misrepresenting the location of service
• Misrepresenting the provider of service
• Waiving the policy deductible and excess
• Incorrect reporting of diagnoses or procedures (including unbundling)
• Overutilisation of services
• Corruption (kickbacks and bribery)
• Issuing false or unnecessary prescription drugs

Developing a reputation in data protection and privacy law, Sue has advised a number of organisations, including general insurers, health care insurers and counter fraud organisations, on the use of personal information (under the Data Protection Act and the GDPR) and the legal implications of sharing data in the domestic market as well as internationally for the detection and prevention of crime/fraud. She is keen to expand this area of her practice as well as advising on an organisation’s compliance obligations generally.

• Law Society
• Criminal Bar Association
• Road Traffic Group
• Personal Injury Group
• Insurance and Re-Insurance Group
• Fraud Group (Defendant) RTA & PI Fraud Counsel
• Fraud Group (Claimant) RTA & PI Fraud Counsel
• Costs Group